Ultrasound findings and tumors of thyroid after head and neck irradiation

Introduction. Thyroid nodules including thyroid cancer are among the common long-term effects of radiation therapy (RT) to the head and neck region administered for primary central nervous system (CNS) tumors and lymphomas.

Aim. To evaluate the frequency and different types of nodules and benign and malignant lesions in thyroid after head and neck irradiation for primary CNS tumors and lymphomas.

Materials and methods. Patients included in the retrospective trial were divided into 6 groups: group 1 – craniospinal irradiation (CSI) for primary CNS tumors under the age of 18 years, group 2 – CSI for primary CNS tumors above the age of 18 years, group 3 – RT to the neck region for lymphoma treatment in patients under the age of 18 years, group 4 – RT to the neck region for lymphoma treatment in patients above the age of 18 years, group 5 – control for patients irradiated before 18 years, group 6 – control for patients irradiated over the age of 18 years.

Results. Thyroid nodules were more common after neck irradiation for lymphoma comparing to CSI (47.1% vs 27%) (p = 0.032). Control groups had even lower nodules rates (p = 0.04). EU-TIRADS 3 were more common after neck irradiation for lympho ma than after CSI (p = 0.013). Female patients developed thyroid nodules more frequently than male (p = 0.001), especially EU-TIRADS 3 and EU-TIRADS 4 (p = 0.027). Furthermore thyroid volume was decreased in patients after irradiation comparing to control groups (p < 0.001).

Conclusions. Thyroid nodules are more common in head and neck irradiation than in general population. As there is a risk of cancer in thyroid nodules, thyroid ultrasound must be performed in patients with irradiation in history. It can help to detect serious lesions and provide appropriate treatment if it needs in time.

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